Jackson Metro Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JACKSON METRO DENTAL LLC

Practice address

102 Wall St
Lexington, MS 39095-3540

Phone

(662) 834-1585

Fax

(662) 834-1583

NPI assigned

Jun 11, 2015

Last updated

Jun 11, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jim H Polles, DDS

Title

Dentist

Phone

(662) 834-1585

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Blake Stewart Bell, DMD

  • General Practice Dentistry
  • Madison, MS
  • NPI 1942043245
  NPD (past)
• Brooke C Bell, DMD

  • Dentist
  • Lexington, MS
  • NPI 1386474930
  NPD (past)
• Charles D Howard, DMD

  • General Practice Dentistry
  • Lexington, MS
  • NPI 1023145430
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1801277207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "address_2": "102 WALL STREET",
            "city": "LEXINGTON",
            "state": "MS",
            "postal_code": "390950297",
            "telephone_number": "662-834-1585",
            "fax_number": "662-834-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WALL ST",
            "city": "LEXINGTON",
            "state": "MS",
            "postal_code": "390953540",
            "telephone_number": "662-834-1585",
            "fax_number": "662-834-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON METRO DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "POLLES",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "662-834-1585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Internal Medicine Clinic of Lexington, Inc
• Intervene Diabetic Center LLC
• Interventional Diabetes Center, LLC
• Isd Renal Inc (Renal Care of Lexington)
• Whitney Ivey
• Jitney Pharmacies Incorporated
• John D. Whitehead (Lexington Medical Supply, LLC)
• Amy Chapman Johnson, FNP-BC
• Samuel Reid Lester, DMD
• Lexington Dental, PLLC

• General Practice Dentistry in Lexington, MS
• Providers in Lexington, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.